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General NPI Number Information
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NPI Number | 1326454463
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Entity Type | Individual
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Provider Name | EVA FRIED M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 05/06/2019
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Provider Practice Location Address
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Address Line | 785 18TH ST
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City | ARCATA
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State | CA
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Zip | 95521
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Country | US
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Telephone | 707-822-2481
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Fax | 707-822-3656
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Provider Business Mailing Address
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Address Line | 670 9TH ST STE 203
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City | ARCATA
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State | CA
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Zip | 95521-6249
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Country | US
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Telephone | 707-826-8633
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD60813114
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A161821
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License Number State | CA
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